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Prospective study of the association between sport-related concussion and brain morphometry (3T-MRI) in collegiate athletes: study from the NCAA-DoD CARE Consortium
  1. Samuel A Bobholz1,
  2. Benjamin L Brett2,
  3. Lezlie Y España1,
  4. Daniel L Huber1,
  5. Andrew R Mayer3,4,5,
  6. Jaroslaw Harezlak6,
  7. Steven P Broglio7,
  8. Thomas McAllister8,
  9. Michael A McCrea2,
  10. Timothy B Meier1,9,10
  11. CARE Consortium Investigators
    1. 1Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
    2. 2Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
    3. 3Neurology and Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
    4. 4The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico, USA
    5. 5Psychology, University of New Mexico, Albuquerque, New Mexico, USA
    6. 6Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
    7. 7Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
    8. 8Psychiatry, Indiana University School of Medicine, Bloomington, Indiana, USA
    9. 9Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
    10. 10Biomedical Engineering, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
    1. Correspondence to Dr Timothy B Meier, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA; tmeier{at}mcw.edu

    Abstract

    Objectives To determine the acute and early long-term associations of sport-related concussion (SRC) and subcortical and cortical structures in collegiate contact sport athletes.

    Methods Athletes with a recent SRC (n=99) and matched contact (n=91) and non-contact sport controls (n=95) completed up to four neuroimaging sessions from 24 to 48 hours to 6 months postinjury. Subcortical volumes (amygdala, hippocampus, thalamus and dorsal striatum) and vertex-wise measurements of cortical thickness/volume were computed using FreeSurfer. Linear mixed-effects models examined the acute and longitudinal associations between concussion and structural metrics, controlling for intracranial volume (or mean thickness) and demographic variables (including prior concussions and sport exposure).

    Results There were significant group-dependent changes in amygdala volumes across visits (p=0.041); this effect was driven by a trend for increased amygdala volume at 6 months relative to subacute visits in contact controls, with no differences in athletes with SRC. No differences were observed in any cortical metric (ie, thickness or volume) for primary or secondary analyses.

    Conclusion A single SRC had minimal associations with grey matter structure across a 6-month time frame.

    • concussion
    • MRI
    • sport
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    Footnotes

    • Twitter @BenjaminBrett1, @JarekHarezlak

    • Collaborators John P. DiFiori (Hospital for Special Surgery); Andrew J. Saykin, Yu-Chien Wu (Indiana University School of Medicine); Kevin M. Koch, Andrew S. Nencka, Yang Wang (Medical College of Wisconsin); Christopher C. Giza, Joshua Goldman (University of California Los Angeles); Kevin M. Guskiewicz and Jason P. Mihalik (University of North Carolina at Chapel Hill); Alison Brooks (University of WisconsinMadison); Stefan M. Duma and Steven Rowson (Virginia Tech).

    • Contributors SAB: analysis and interpretation of data; drafting the work; final approval; agreeing to be held responsible for work. BLB: analysis and interpretation of data; drafting the work; final approval; agreeing to be held responsible for work. LYE: analysis and interpretation of data; revising the work for intellectual content; final approval; agreeing to be held responsible for work. DLH: analysis and interpretation of data; revising the work for intellectual content; final approval; agreeing to be held responsible for work. ARM: analysis and interpretation of data; revising the work for intellectual content; final approval; agreeing to be held responsible for work. JH: analysis and interpretation of data; revising the work for intellectual content; final approval; agreeing to be held responsible for work. SPB: conception of the work; data acquisition; revising the work for intellectual content; final approval; agreeing to be held responsible for work. TMc: conception of the work; data acquisition; revising the work for intellectual content; final approval; agreeing to be held responsible for work. MAM: conception of the work; data acquisition; revising the work for intellectual content; final approval; agreeing to be held responsible for work. TBM: conception of the work; analysis and interpretation of data; drafting the work; revising the work for intellectual content; final approval; agreeing to be held responsible for work. CARE Consortium Investigators Group Author Block (listed alphabetically by institution): John P. DiFiori MD (Hospital for Special Surgery); Andrew J Saykin PsyD and Yu-Chien Wu MD, PhD (Indiana University School of Medicine); Kevin M Koch PhD, Andrew S Nencka PhD, and Yang Wang MD, PhD (Medical College of Wisconsin); Christopher C Giza MD and Joshua Goldman MD, MBA (University of California Los Angeles); Kevin M Guskiewicz PhD, ATC and Jason P Mihalik PhD, CAT(C), ATC (University of North Carolina at Chapel Hill); Alison Brooks MD (University of Wisconsin-Madison); Stefan M Duma PhD and Steven Rowson PhD (Virginia Tech). All block authors provided substantial contribution to the acquisition of data; revising the work critically for intellectual content; final approval of manuscript; and agreement to be held responsible for work.

    • Funding This project was funded with support from the Grand Alliance Concussion Assessment, Research, and Education Consortium, funded, in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense. The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21 702–5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Programme under Award NO W81XWH-14-2-0151. TM acknowledges additional support from the National Institute of Neurological Disorders And Stroke (R01NS102225; R21NS099789) and through a project funded through the Research and Education Programme, a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin. BLB acknowledges support from the National Institute of Neurological Disorders and Stroke under the National Institutes of Health under the award NO L301L30NS113158-01.The REDCap electronic database used for this project was supported by the National Centre for Advancing Translational Sciences, National Institutes of Health, Award Number UL1TR001436.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data used in this manuscript are publicly available through the Federal Interagency Traumatic Brain Injury Research informatics system.

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